CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: The Children's Mercy Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $46
Cash Discount Price: $34
vs. Medicare Baseline: 7.65x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at The Children's Mercy Hospital is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 7.65x the Medicare baseline. Located in 2401 Gillham Road, Kansas City, MO.

Cash / Self-Pay

$34

Average discount available for prompt cash payment at this facility.

Insurance Median

$46

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$6.01

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $6.01 (100%)

Cash / Self-Pay: $34 (566%)

Insurance Median: $46 (765%)

Cash: $34 (566% of Medicare)

Ins. Median: $46 (765% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $6.01 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 765% of the Medicare baseline (a markup of 665%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Healthy Blue	$6 - $16	100%
Medicaid / KanCare	$6	100%
UnitedHealthcare	$6 - $48	100%
Home State Health	$14	233%
Blue Cross Blue Shield	$29 - $53	483%
Cigna	$34 - $49	566%
Medica	$41	682%
Aetna	$43 - $48	715%
Centivo	$46	765%
Health Midwest Comprehensive Care	$46	765%
Nebraska Furniture Mart	$46	765%
Orscheln	$46	765%
Quiktrip	$46	765%
Wellfit/Centrus	$46	765%
Wppa Providrs Care	$46	765%
Humana	$47	782%
Coventry Health Care Of Kansas	$53	882%
Coxhealth Network	$53	882%
Mercy Health	$53	882%
Multiplan	$54	899%
American Healthcare Alliance	$60	998%
Healthlink	$62	1032%
National Preferred Provider Network	$64	1065%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $34.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85730.

Insurance In-Network Protection Plan

Contact your insurance company to confirm The Children's Mercy Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 85730.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.